Healthcare Provider Details

I. General information

NPI: 1891763264
Provider Name (Legal Business Name): ASHLEY L BYRGE C.PH.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ASHLEY L BOTTS C.PH.T.

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 BAKER HWY SUITE #1
HUNTSVILLE TN
37756-4168
US

IV. Provider business mailing address

375 NELSON LN
PIONEER TN
37847-2742
US

V. Phone/Fax

Practice location:
  • Phone: 423-663-9355
  • Fax: 423-663-3992
Mailing address:
  • Phone: 423-663-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: